American journal of diseases of children

BRUSH, JOHN MITCHELL

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060002001

Throughout several years' observation the uniformity of the clinical response of children with diabetes mellitus to the treatment of the initial episode of glycosuria has been brought forcibly to our attention. Such uniformity is attained, to be sure, only when certain therapeutic policies and practices are observed. When this is done, however, the course of one patient conforms so closely to that of the next that it has been possible to predict that in the majority of instances, irrespective of the condition of the patient when treatment is begun, a previously untreated diabetic child will be discharged from the hospital within twenty-two to thirty days after admission on an adequate, "normal" diet, in a stable state, free from glycosuria and from hypoglycemic shock and requiring a single daily injection of 2 to 8 units of regular insulin. The regimen by which these results are achieved will be described later in

MACKLIN, MADGE THURLOW

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060018002

In 1912, Rautmann1 first applied the term Erythroblastose to a condition in a hydropic fetus in which there was evidence of excess hemopoiesis in the liver, spleen and kidney. Since that time the term has been used to designate a group of conditions including fetal hydrops, fatal jaundice of the newborn and congenital anemia. Since the discovery of the Rh factor by Landsteiner and Wiener2 and the application of the knowledge gained through this discovery to the problem of erythroblastosis by Levine and his associates,3 the term has been employed to designate the condition arising through incompatibility of blood factors between mother and fetus. Confusion now exists in the literature as to what constitutes erythroblastosis. There are those who state that hemolysis is the distinguishing feature of the condition; others state that the essential criterion is the presence in the fetus, at or near term, of extramedullary

ANDERSON, NINA A.; SAGE, DOROTHY N.; SPAULDING, E. H.

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060023003

Oral moniliasis occurs frequently in newborn infants and probably is exceeded only by impetigo neonatorum in its incidence in nurseries for newborn infants. This study was undertaken to investigate further some of the factors which may be related to the incidence, the source and the spread of oral moniliasis in newborn infants. Oral swabs were obtained from apparently normal newborn infants in order to investigate the frequency with which they contained Monilia and to study oral moniliasis preclinically, if perchance thrush developed later in any of the infants. Vaginal swabs were obtained from the mothers of some of these infants during labor and/or at delivery in order to determine the relationship between maternal vaginal and infantile oral moniliasis. Whenever thrush of the mouth became clinically manifest in infants not in the group being studied, laboratory confirmation of the diagnosis was attempted by culturing oral swabs for Monilia (Candida) albicans. On

COOPERSTOCK, M.

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060030004

Several years after the introduction of the mechanical respirator Smith1 called attention to the fact that one third of the patients who had been in respirators and were discharged to various orthopedic hospitals and convalescent homes died with infections of the respiratory tract, reported in the hospital records as bronchopneumonia. A review of the records of 2 such patients and postmortem studies on a third led him to believe, however, that the pulmonary infections develop secondarily to atelectasis produced by obstruction of the bronchi by unexpelled exudate. Coryllos and Birnbaum2 had previously emphasized the importance of the role of atelectasis in the development of pneumonia, and there has since developed a considerable interest with regard to the mechanical effects of obstructing bronchial exudate in infections of the respiratory tract in general. In paralysis of the respiratory muscles due to poliomyelitis a number of factors predispose to the development

KOHN, JEROME L.; SCHWARTZ, IRVING; GREENBAUM, JEROME; DALY, MARY M. I.

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060036005

Roentgenograms of the chest taken during the course of pertussis were first described by Gottlieb and Möller,1 more than twenty years ago. The subject has recently been excellently reviewed by Lapin2 and Maggi.3 Often they found no clinical evidence or physical sign corresponding to the changes noted in roentgenograms of the lungs. Careful pathologic studies of lungs of children who died of pertussis were made by Feyrter,4 Hayakawa5 and others. These lungs on gross examination showed scattered areas of consolidation and atelectasis. Some authors emphasized enlargement of the lymph nodes in the hilar region as a contributing cause of symptoms. Histologic examination showed mainly peribronchial infiltration, with infiltration of the adjacent alveoli and interstitial thickening of the alveolar walls. Areas of atelectasis and emphysema were also seen frequently. The changes seen in roentgenograms were therefore thought to be caused by the pulmonary conditions previously described

KRIETE, FREDERIC A.; EPSTEIN, HAROLD C.; TOOMEY, JOHN A.

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060042006

THE LEVINSON RATIO In 1917 Tashiro and Levinson1 described a test of the spinal fluid which was considered diagnostic for tuberculous meningitis. It was based on differential precipitation of the proteins of the spinal fluid by mercury bichloride and by sulfosalicylic acid, depending on the pH of the fluid. The result of the test, known as the Levinson ratio, is considered positive if the amount of precipitate obtained by the action of mercury bichloride on the spinal fluid is at least twice as great as that obtained by the action of sulfosalicylic acid. Several studies2 made since that time indicate that the Levinson ratio is positive for 78 to 100 per cent of specimens of spinal fluid obtained from patients ill with tuberculous meningitis. Less agreement is to be found in the results from control tests of spinal fluids taken from normal persons and from patients ill

GLEICH, MORRIS; BLUMBERG, MARVIN L.; MASON, ALVIN S.

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060045007

There is still an appreciable incidence of neonatal gonococcic conjunctivitis in spite of legislation in forty-six of the United States requiring the instillation of silver compounds into the conjunctival sacs of every baby at birth.1 From 1938 through 1942, 222 cases were reported in the city of New York2 and 562 cases in the state of New Jersey.3 The total number of cases reported from 1939 through 1943 in the city of New York in the municipal hospitals alone was 126.4 An investigation was carried out in the service for newborn infants at Harlem Hospital in order to prove the value of sulfathiazole in the prevention of gonococcic conjunctivitis. The routine instillation of silver nitrate into the conjunctival sacs of newborn infants was supplemented with the oral administration of sulfathiazole. Beginning Feb. 1, 1943, sulfathiazole was given orally, as a prophylactic, to all babies born in

MCKINLEY, JOHN B.; JACKSON, ROBERT L.

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060047008

The erythrocyte sedimentation test is a laboratory procedure which may be of some help in diagnosing rheumatic fever and is known to be of definite aid in evaluating the clinical conditions of patients with this disease. During the acute and subacute or active phases of rheumatic fever it is common practice to obtain sedimentation values rather frequently to help in following the course of the disease. The most important use of the sedimentation values is as an aid in determining when the disease passes from the active to the inactive phase. After the infection has subsided, the physical activity of the patient can be increased safely. Clinically there is little need for taking frequent readings until the patient's general condition is such that there is a real question as to whether the disease is active or inactive. After the infection has subsided and the disease is inactive, it is common

BLATT, MAURICE L.; ZELDES, MARY; GOODFRIEND, JAMES

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060053009

In 1927 Fairbank1 described "stippled epiphyses" associated with dwarfism, but he failed to recognize thyroid deficiency as the basis of the disturbance. Ten years later (1937) Reilly and Smythe2 described 5 similar cases, designating the condition as "cretinoid epiphysial dysgenesis." McCullough and Sutherland3 in 1940 described stippled epiphyses in a dwarf in whom there was no sign of hypothyroidism and used the term "epiphysial dysplasia puncticularis" to designate the skeletal change. The patient was not given thyroid, but McCullough and Sutherland stated that he increased in stature when treated with calcium, vitamin D and androgen. Wilkins,4 who found bilateral epiphysial dysgenesis in 23 of 25 children with hypothyroidism, said that he had never seen true dysgenesis in any type of dwarfism other than that occurring with hypothyroidism. In his extensive review of the subject he cited reports of 36 cases observed by Läwen,5 Roth,6

LITVAK, ABRAHAM M.; APPELBAUM, EMANUEL; GREENE, MORTON

1944 American journal of diseases of children

doi: 10.1001/archpedi.1944.02020060058010

Prior to the introduction of the sulfonamide compounds pneumococcic meningitis was almost invariably fatal. With the advent of these drugs, particularly sulfapyridine and sulfadiazine, the prognosis for patients with meningitis of this type was considerably improved. The introduction of penicillin marked another advance in the treatment of this disease. However, the number of reported recoveries from pneumococcic meningitis following penicillin therapy has up to the present time remained small. It has therefore seemed worth while to place on record our case, admission revealed an injected pharynx and a temperature of 102.6 F. Sulfadiazine was prescribed, but after the first dose of the drug a generalized convulsion supervened, lasting thirty or forty minutes. Sulfadiazine therapy was discontinued. The infant's condition remained stationary for the next twenty-four hours. However, the convulsions recurred the next morning, and the infant was brought to the emergency room of the hospital. The history of the birth,